Perspectives on antiviral use during pandemic influenza
Identifieur interne : 000F66 ( Istex/Corpus ); précédent : 000F65; suivant : 000F67Perspectives on antiviral use during pandemic influenza
Auteurs : Frederick G. HaydenSource :
- Philosophical Transactions of the Royal Society B: Biological Sciences ; 2001.
Abstract
Antiviral agents could potentially play a major role in the initial response to pandemic influenza, particularly with the likelihood that an effective vaccine is unavailable, by reducing morbidity and mortality. The M2 inhibitors are partially effective for chemoprophylaxis of pandemic influenza and evidence from studies of interpandemic influenza indicate that the neuraminidase inhibitors would be effective in prevention. In addition to the symptom benefit observed with M2 inhibitor treatment, early therapeutic use of neuraminidase inhibitors has been shown to reduce the risk of lower respiratory complications. Clinical pharmacology and adverse drug effect profiles indicate that the neuraminidase inhibitors and rimantadine are preferable to amantadine with regard to the need for individual prescribing and tolerance monitoring. Transmission of drug-resistant virus could substantially limit the effectiveness of M2 inhibitors and the possibility exists for primary M2 inhibitor resistance in a pandemic strain. The frequency of resistance emergence is lower with neuraminidase inhibitors and mathematical modelling studies indicate that the reduced transmissibility of drug-resistant virus observed with neuraminidase inhibitor-resistant variants would lead to negligible community spread of such variants. Thus, there are antiviral drugs currently available that hold considerable promise for response to pandemic influenza before a vaccine is available, although considerable work remains in realizing this potential. Markedly increasing the quantity of available antiviral agents through mechanisms such as stockpiling, educating health care providers and the public and developing effective means of rapid distribution to those in need are essential in developing an effective response, but remain currently unresolved problems.
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DOI: 10.1098/rstb.2001.1007
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Hayden</name><affiliation><mods:affiliation>Department of Internal Medicine, PO Box 800473, University of Virginia Health Sciences Center, Charlottesville, VA 22908, USA Jgh@virginia.edu</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:B21919870596C214E7E30F35E6DA13388F4ED3B6</idno><date when="2001" year="2001">2001</date><idno type="doi">10.1098/rstb.2001.1007</idno><idno type="url">https://api.istex.fr/ark:/67375/V84-SJRB2SG7-M/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">000F66</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000F66</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">Perspectives on antiviral use during pandemic influenza</title><author><name sortKey="Hayden, Frederick G" sort="Hayden, Frederick G" uniqKey="Hayden F" first="Frederick G." last="Hayden">Frederick G. Hayden</name><affiliation><mods:affiliation>Department of Internal Medicine, PO Box 800473, University of Virginia Health Sciences Center, Charlottesville, VA 22908, USA Jgh@virginia.edu</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Philosophical Transactions of the Royal Society B: Biological Sciences</title><title level="j" type="issue">Discussion Meeting Issue ‘The origin and control of pandemic influenza’ organized by G. Laver and R. G. Webster</title><imprint><publisher>The Royal Society</publisher><date type="published">2001</date><biblScope unit="vol">356</biblScope><biblScope unit="issue">1416</biblScope><biblScope unit="page" from="1877">1877</biblScope><biblScope unit="page" to="1884">1884</biblScope></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Antiviral agents could potentially play a major role in the initial response to pandemic influenza, particularly with the likelihood that an effective vaccine is unavailable, by reducing morbidity and mortality. The M2 inhibitors are partially effective for chemoprophylaxis of pandemic influenza and evidence from studies of interpandemic influenza indicate that the neuraminidase inhibitors would be effective in prevention. In addition to the symptom benefit observed with M2 inhibitor treatment, early therapeutic use of neuraminidase inhibitors has been shown to reduce the risk of lower respiratory complications. Clinical pharmacology and adverse drug effect profiles indicate that the neuraminidase inhibitors and rimantadine are preferable to amantadine with regard to the need for individual prescribing and tolerance monitoring. Transmission of drug-resistant virus could substantially limit the effectiveness of M2 inhibitors and the possibility exists for primary M2 inhibitor resistance in a pandemic strain. The frequency of resistance emergence is lower with neuraminidase inhibitors and mathematical modelling studies indicate that the reduced transmissibility of drug-resistant virus observed with neuraminidase inhibitor-resistant variants would lead to negligible community spread of such variants. Thus, there are antiviral drugs currently available that hold considerable promise for response to pandemic influenza before a vaccine is available, although considerable work remains in realizing this potential. Markedly increasing the quantity of available antiviral agents through mechanisms such as stockpiling, educating health care providers and the public and developing effective means of rapid distribution to those in need are essential in developing an effective response, but remain currently unresolved problems.</div></front></TEI><istex><corpusName>rsl</corpusName><author><json:item><name>Frederick G. 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The frequency of resistance emergence is lower with neuraminidase inhibitors and mathematical modelling studies indicate that the reduced transmissibility of drug-resistant virus observed with neuraminidase inhibitor-resistant variants would lead to negligible community spread of such variants. Thus, there are antiviral drugs currently available that hold considerable promise for response to pandemic influenza before a vaccine is available, although considerable work remains in realizing this potential. 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